Month: January 2018

If you don’t have diabetes (and you speak a little Spanish), you might think I’ve come up with a new intention for how I want to live my life, sort of a ‘take it easy’ non-attachment type attitude. She’s livingfree style, libreman. But if you do have diabetes, you’ve probably checked your bg on a FreeStyle meter and at least heard of the new device that was just approved for sales in the U.S., the FreeStyle Libre.

I both like and hate the tendency of medical companies to give chronic illness management supplies names that inspire images of smiling people flying kites on the beach without a care. I dislike this tendency because it’s a false promise. These words couldn’t attract us to the product if it wasn’t true that diabetes, like many chronic conditions, imposes it’s own barriers. I won’t talk about those right now – maybe later. But what I like, is that these companies are recognizing what is truly hard about diabetes: notsimply the pain of finger pricks or shots, but the hassle, the baggage, the constant back-of-the-mind thought (as covered previously) that it inspires.

For the past few weeks, I’ve really been wanting a break. There’s nothing to do with this desire, no accrued vacation time to take, no money to spend that can buy it. And yes, there are some strategies that one could employ to alleviate some of the pressure in these moments, but even thinking those up and navigating their implementation is the opposite of a break. It’s effort. A lot of effort.

In case you’re not familiar, the FreeStyle ‘reader’ looks like a normal blood sugar meter, but it is equipped to scan a little sensor, about the size of a large quarter, that you wear on the back of your upper arm, in order to measure blood sugar in interstitial fluid. I bought myself a reader and three sensors. For the past ten days, I could know my blood sugar anytime I wanted to, but not when I didn’t. Unlike a continuous glucose monitor (CGM), which I’ve always resisted, the Libre let me remain in control of the amount of information I receive. As someone prone to over-management, this is ideal.

A couple of specific examples:

Saturday night I was driving myself and a couple of friends to a concert. About 30 minutes before leaving I scanned the sensor on my arm. 90 mg/dl. 5 minutes later I scanned again 85 mg/dl. I was dropping a little. I ate half a tablespoon of honey. 10 minutes later I scanned: 95 mg/dl – stabilizing and good to drive, probably some fat and protein from my dinner hitting me now too. Because of the Libre, I was able to monitor while getting ready without poking my finger 3 or 4 times in 20 minutes and getting blood on my outfit. I could eat the right amount of carbs so as not to skyrocket into high bg, but also allow me to drive, and be ready on time without stress.

Another night, I was about to go into the movie theatre with a friend (a lot of recreation this past week) and wanted to have some popcorn, which is my fav. We’re in line, just a few minutes ahead of start time, I’m wearing gloves, a puffy coat, and holding my wallet. I scan, bg is a little low, and I know how much insulin to take once we find our seats. Again, no fumbling, no blood, no running out of time. I feel magical, like a superhuman.

So here it is, the day after my sensor ended and I haven’t put on a new one yet. I feel like I just got back from a diabetes vacation. I feel restored. I’ll put the new sensor on soon, but I’m rationing them, because my insurance plan still doesn’t cover them, and while they are relatively affordable out-of-pocket compared to a CGM, test strips, or an insulin pump, they still feel like an indulgence at this point.

Indulgence. It shouldn’t be an indulgence to know what your blood sugar is, right? I feel like it should be, how do I want to say this…a basic human right. But it does feel like an indulgence, because I know that my many of my friends in Bolivia and elsewhere who are living with diabetes, can’t afford to check their blood sugar more than twice a day, on a good day. Here I am, able to scan willy-nilly, a luxurious level of management that is not at all equitable across the globe. And it is an injustice.

Today is Martin Luther King, Jr. Day – a day to celebrate the undeterred pursuit of social justice. It’s not always clear what this means or what the clearest path to it might be, and I often find myself uncertain of how to nourish solutions rather than feeding problems. In this situation, there are big questions I have to ask myself when it comes to wearing this device while others can’t. I haven’t answered them yet, but I do know that this is a situation to at the very least, recognize my privilege and remain aware that the current state of inequity in access to medical care and technology is not OK. It’s also a time, I think, like many (most? all?), to be grateful. I’m grateful to the developers of this technology, to those who’ve funded the research behind it, those who’ve advocated for its coverage by Medicare, those who will tirelessly advocate for other insurance plans to cover it, and for the new found freedom it has afforded me. Finally, it’s a time for action, to ensure that all children and adults with diabetes can enjoy more freedom from disease and greater opportunity for wellness.